Intro to Wellness and Health Promotion

What is wellness

Concepts that embrace positive health behaviors that promote a state of physical and mental balance and fitness

What is the operational definition of wellness

Contributions to the overall health of an individual

When does wellness occur during disease development

Before

When does wellness occur during treatment

During

When does wellness occur during discharge

After

What are key questions to ask a patient in regards to their wellness

How can we keep people from developing conditions
How can we help those with conditions and impairments
How can we help those with conditions from getting worse
How can we help people feeling their best

PT considerations

Maintenance, prevention, and wellness

What is the PT role in wellness

Promote health and wellness
Encourage healthy behaviors
Help individuals with chronic conditions engage in physical activity

What is the APTA statement in regards to wellness

Maintain, achieve, and restore optimal functional capacity
Minimize impairments, functional limitations, and disabilities related to congenital and acquired conditions
Create a sense of wellbeing that can prevent further deteriorations or future illness
Create appropriate environmental adaptations to enhance independent function

What are other wellness healthcare professionals

athletic trainers
chiropractors
dentists
dieticians
exercise physiologists
massage therapists
MDs, DOs
mental health counselor
occupational therapists
podiatrists
psychologists
recreational therapists
social workers
speech therapists
wellness coaches

What are the 3 steps to referrals in wellness

Identify overreaching goals
Extract portions of the goals PTs are qualified to assist with
Recognize if other systems needs to be addressed

What are the components of evaluating wellness

Examination
Evaluation
Diagnosis
Prognosis
Interventions
Outcomes

During a wellness exam what are important parts of the history

Weight, body image, related surgeries
Family history
Fitness-related resources
Behavioral health risks
Mental, psychological, and social disorders
Prior level of activity

During a wellness exam what are important parts of the systems review

Integumentary
Mental status
Musculoskeletal
Neuromuscular
Nutritional wellness
Wellness challenges

During a wellness exam what are important parts of the tests and measures

Aerobic capacity
Resting metabolic rate
Body composition
Mobility
Muscular fitness

What is the prognosis based on

Based on the goals

What influences the plan of care

Goals and resources available

Can PTs get paid for wellness care

No

What is health promotion

The process of enabling people to increase control over, and to improve their health
Assessment of healthy lifestyle behaviors that can improve or sustain well-being and prevent or reduce risk for chronic conditions

How is health promotion incorporated in patient populations

Weight bearing and weight training exercise programs
Strength training, gait training, balance, and coordination activities
Cardiovascular condition, strengthening, and instructions in ADLs

How is health promotion incorporated at the individual level

Help guide patients where they need to be
Provide support for behavior change

Exercise programs to prevent or reduce the development of sequelae in individuals with lifelong conditions is an example of what type of health promotion

Prevention

Development and delivery of healthy lifestyle programs for individuals to reduce risk of obesity, diabetes, or help with BP lowering is an example of what type of health promotion

Prevention

Workplace redesign, strengthening, stretching, endurance exercise programs, education, and postural training to prevent and manage low back pain is an example of what type of health promotion

Work place injury prevention

Health coaching to support the development of behaviors that prevent disease and disability and enable achievement of life goals is an example of what type of health promotion

Community engagement

Broad based consumer education and advocacy programs to prevent health problems is an example of what type of health promotion

Community engagement

What are the stages of readiness for change

Precontemplation
Contemplation
Preparation
Action
Maintenance
Termination

Precontemplation

Inactive
Not considering making a change
May be unaware of need for change

Precontemplation strategies

Bring awareness and increase motivation

Contemplation

Acknowledge need for change
Weighing pros and cons of the behavior and potential change

Contemplation strategies

Explore motivations and address ambivalence
Create pro/con list

Preparation

Ready to take action
Making plans for change
Gathering information
Seeking support
Setting goals

Preparation strategies

Help set realistic goals and development plan of action

Action

Actively making efforts to implement change
Changes in behavior, environment or lifestyle are visible

Action strategies

Maintaining motivation, building resilience, seeking support

Maintenance

Make changes to prevent relapse
Solidifying new habits and routines

Maintenance strategies

Building a support network, managing setbacks, practicing self-care, identify areas to address to prevent burnout

Termination

Desired change is engrained
No risk of relapse

Termination strategies

Celebrate success

Motivational interviewing

Technique to assist patient in reaching goals
Question based
Assist patient in finding answers on their own
Questions come from a place of wanting to learn about the patient

Life stressors to consider with motivational interviewing

Work
Home
Family
Events
Sleep

Motivational Interviewing: Parternship

Collaborative between you and patient

Motivational Interviewing: Evocation

Building intrinsic motivation

Motivational Interviewing: Acceptance

Meeting patient where they are

Motivational Interviewing: Compassion

Work towards the patient’s best interest/their goal

Motivational Interviewing Strategies: Open ended questions

Questions that require more than a yes/no response

Motivational Interviewing Strategies: Reflective listening

Mirror back what is heard to ensure clarity and understanding

Motivational Interviewing Strategies: Affirmations

Acknowledge strengths and efforts

Motivational Interviewing Strategies: Scaling questions

Ask for a rating on a scale of 0 to 10 and then ask why that number was chosen